A&W (Malaysia) Sdn Bhd (5168-X)

PERMOHONAN UNTUK PEKERJAAN

APPLICATION FOR EMPLOYMENT
Nota/Note:
1 Sila baca seluruh borang permohonan dengan teliti dan lengkapkannya dalam HURUF BESAR.
Please read through the application form carefully and complete it in BLOCK LETTER.

2 Selepas dilengkapkan borang ini hendaklah dikembalikan beserta dengan satu (1) keping gambar Gambar Terbaru
berukuran passport. Latest Photograph
The application form upon completion is to be returned with one (1) passport size photograph.

3 Sila lampirkan salinan sijil-sijil / surat akuan bersama borang ini. Sijil-sijil asal hendaklah dibawa
bersama semasa temuduga.
Please attach copies of relevant certificates / testimonials to this form. Originals are to be
produced at the interview

JAWATAN DIPOHON: GAJI YANG DIPOHON:

POST APPLIED FOR: SALARY EXPECTED:
A. BUTIR-BUTIR PERIBADI / PERSONAL DETAILS
1 Nama Penuh:
Full name:

2 Alamat: 3 No. Tel. (Rumah):

Address: Tel. No. (House):
No. Tel. (Bimbit):
Tel. No. (Handphone):
Email Address:

4 Tarikh Lahir dan Umur: 5 Tempat Lahir:

Date of Birth and Age: Place of Birth:

6 No K.P / Passport: 7 Tempat / Tarikh Dikeluarkan:

I.C. / Passport No: Place / Date Issued:

8 Warganegara: 9 Bangsa: 10. Agama

Nationality: Race: Religion

11 Bahasa: (Pertuturan) (Tulisan)

Languages: (Spoken) (Written)

12 No. KWSP: 13. No. PERKESO: 14. No. Cukai Pendapatan:

EPF No: SOCSO No: Income Tax No:

15 Status Perkahwinan: Bujang / Kahwin 16 Nama Suami / Isteri:

Marital Status: Single / Married Name of Spouse:

17 Pekerjaan Suami / Isteri: 18 Nama Syarikat:

Occupation of Spouse: Name of Company:

19 Butir-butir Anak:
Details of Children:

Nama/Name Umur/Age Jantina/Sex Jika belajar nyatakan

"Tanggungan"
If studying, indicate as
"Dependant"
a.
b.
c.
d.
e.
B. BUTIR - BUTIR KELUARGA / FAMILY DETAILS
1 Nama Bapa: 2 Pekerjaan:
Father's Name: Occupation:

3 Nama Emak: 4 Pekerjaan:

Mother's Name: Occupation:

5 Nama Adik-beradik / Umur/Age Jantina/Sex Pekerjaan/Occupation

Name of Siblings
a
b
c
d
e

C. BUTIR-BUTIR PENGAJIAN / EDUCATION DETAILS

Nama Sekolah / School Name Dari / From Hingga / To Kelulusan / Qualification Butir-butir Pencapaian
(Cth: Ijazah Sarjana Muda Kulinari)
(S.M. Tanjung Sepat) (mm/yyyy) (mm/yyyy) Grades Achieved
(e.g.: Bachelor Degree in Culinary)

Nama Universiti / Kolej

University / College's name

Lain-lain Kursus
Other Courses Completed

Kursus yang Sedang Diikuti

Courses Currently Attending

Biasiswa yang Diterima Perbadanan / Institusi Jumlah / Nilai

Scholarships Received Organisation / Institution Amount (RM)

D. KEGIATAN-KEGIATAN / ACTIVITIES
Sekolah / Kolej / Universiti Sukan/ Permainan/ Kegemaran Ahli Kelab, Persatuan dll. Jawatan yang
School / College / University Sports / Games / Hobbies Membership of Clubs, Societies, disandang
Associations, etc. Positions held

Sekarang
At present
E PENGALAMAN BERKERJA / WORK EXPERIENCE
1 Pekerjaan Terkini / Latest Employment
Tarikh Bermula (Bulan/Tahun) Nama Syarikat
Date Joined (Month/Year) Company Name

Jawatan sekarang Alamat Syarikat

Present job title Company Address

Melapur kepada (Name/Jawatan)

Reporting to (Name/Job title)

Bilangan Kakitangan yang Anda Selia Jenis Perniagaan

No. of staff you Supervise Nature of Business

Gaji Permulaan Gaji Sekarang Elaun (Jenis/Jumlah)

Starting Salary Present Salary Allowances (Type/Amount)

Sebab-sebab Anda Ingin Memohon Jawatan Lain

Reason for Applying for A New Position

Notis Berhenti yang Diperlukan Tarikh Boleh Melapur Diri

Resignation Notice Period Required Date Available for Employment

Tugas-tugas Lukiskan Carta Organisasi dan Kedudukan Anda

Key Duties (Tandakan X)
Complete an organization chart showing your position
in the organization (mark X)

2 Lain-lain Pengalaman Berkerja / Other Relevant Work Experience

Dari / From Hingga / To Nama Syarikat Jawatan Gaji Terakhir Sebab Berhenti
(mm / yyyy) (mm / yyyy) Company Name Job Title Last Salary Reasons of Leaving
F PERUJUK / REFERENCES

Sila nyatakan nama, alamat dan jawatan dua orang perujuk peribadi yang bukan ahli keluarga pemohon
yang boleh memberikan maklumat berkaitan pekerjaan pemohon.
List the names and contact details of two referees who are not members of your family who can provide
details on candidate's work experience.

Nama: Nama:

Name: Name:

Jawatan: Jawatan:
Job Title: Job Title:

No. Tel: No. Tel:

Tel. No: Tel. No:

Hubungan: Hubungan:
Relationship: Relationship:

Syarikat: Syarikat:
Company: Company:

Tempoh Dikenali: Tempoh Dikenali:

Years of Acquaintance: Years of Acquaintance:

G AKUAN / DECLARATION
*potong yang tidak berkenaan / Delete which is not relevant.

1a Adakah anda mempunyai lain sumber pendapatan sendiri? YA / TIDAK

Do you have any other independent means or source of income? YES / NO

b Jika ya, sila nyatakan punca dan nilai pendapatan tersebut.
If yes, please state the source and amount of income.

2a Adakah anda menyandang jawatan pengarah di mana-mana syarikat? YA / TIDAK

Are you a director for any companies? YES / NO

b Jika ya, sila nyatakan nama syarikat tersebut, jumlah saham yang dimiliki dan jawatan yang disandang.

If yes, please state name of the company, amount of shares owned and/or the positions you are holding.

3a Adakah anda sekarang atau pernahkah anda memegang sebarang jawatan di dalam
mana-mana pertubuhan sosial, profesional atau politik? YA / TIDAK
Are you presently or have you ever held any position in political, social or YES / NO
professional organizations?

b Jika ya, sila nyatakan nama pertubuhan dan jawatan yang disandang.

If yes, please give their names and the positions you are/were holding.

4a Adakah anda seorang muflis atau pernah diisytiharkan muflis? YA / TIDAK

Are you a bankrupt or have you ever been declared a Bankrupt? YES / NO
b Jika ya, sila nyatakan maklumat mengenai muflis.
If yes, please state information about bankruptcy.
5a Adakah anda pernah didakwa, dituduh, didapati bersalah dalam sebarang kesalahan, YA / TIDAK
jenayah, salah laku dan prestasi kerja tidak memuaskan di syarikat yang pernah anda
bekerja? YES / NO
Have you ever been charged, accused, found guilty of any offence, crime, misdemeanor and
unsatisfactory work performance in the company you have worked for?
b Jika ya, sila nyatakan dan berikan informasi yang teliti.
If yes, please elaborate and provide detailed information.

6a Adakah anda mengidapi penyakit yang serius dan/atau kecacatan? YA / TIDAK

Do you have any major medical illnesses and/or disabilities? YES / NO

b Jika ya, sila nyatakan jenis penyakit yang dihidapi dan/atau kecacatan.
If yes, please provide details on nature of your illness and/or disability.

7a Adakah anda memiliki lesen memandu? YA / TIDAK

Do you possess a driving license? YES / NO
b Jika ada, sila nyatakan Kelas:
If yes, please state the Class:

8 Saya mengaku bahawa maklumat di atas adalah benar pada pengetahuan saya. Selepas diterima berkerja, jika
diketahui yang saya telah membuat pengisytiharan palsu mengenai sebarang maklumat berkenaan, Syarikat berhak
untuk menamatkan perkhidmatan saya tanpa notis.

I declare that the above information is to the best of my knowledge and true. If after engagement and/or start work, it is
found that I have made a false declaration on any information regarding, the Company reserves the right to terminate my
service without any notice.

Tarikh: Tandatangan Pemohon:

Date: Signature of Applicant:

For office used only:

Interviewer feedback: To Offer / Reject / KIV for other position ......................................... (pls state)

Allowance
Proposed Position Location / Dept Start Date Basic Salary
(if any, pls state)

Signature / Approval

Interviewer's Signature: Job Title:

Interviewer's Name: Date:

HOD's Signature: Job Title:

HOD's Name Date:

PCD/03.2023